Mobilization of the breast off the chest wall for mastectomy

Mobilization of the breast off the chest wall can be aided by placing Allis clamps along the superior border of the breast, including the investing "fascia" of the muscle (perimysium). The tissue is pulled up or inferiorly with gentle traction. The dissection is performed utilizing electrocautery or sharp dissection, traveling in parallel to the chest wall muscle fibers. Since the pectoralis major muscle fibers splay, the angle of dissection shifts as one progresses within the dissection.